medigraphic.com
SPANISH

Medicina Crítica

  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • Policies
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2017, Number 3

<< Back Next >>

Med Crit 2017; 31 (3)

Development of a modified, simplified nutritional risk score (NUTRIC) in critically ill patients

Cruz GLM, Galindo MCA, Monares ZE, Pérez GBS, Aportela VVA, Rodríguez GJH, Sánchez NVM
Full text How to cite this article

Language: Spanish
References: 7
Page: 140-144
PDF size: 221.79 Kb.


Key words:

Nutritional, critically ill, NUTRIC score, assessment.

ABSTRACT

Introduction: The NUTRIC score is one of the tools proposed for nutritional risk assessment in critically ill patients. This score uses two severity scores: Acute Physiology and Chronic Evaluation II (APACHE II) and Sequential Organ Failure Assessment score (SOFA), which generates a high risk for collinearity.
Methods: The goal of the present study is to eliminate the collinearity between the APACHE II and the SOFA used in the NUTRIC score, optimizing such tool. Two alternative scales were developed: modified NUTRIC with an adjustment for APACHE II, by eliminating the points given by the APACHE II and obtaining an adjustment coefficient through linear regression, and the NUTRIC without APACHE II. ROC curves were built to determine the performance of both scores for detecting nutritional risk.
Results: Two hundred twenty five patients where included in the study. Linear regression between the conventional NUTRIC score and the NUTRIC without APACHE II showed a Pearson coefficient of 0.918, r2 = 0.843, p ‹ 0.05, m = 1.368, b = 0, and the modified NUTRIC, a Pearson coefficient of 0.918, r2 = 0.843, p ‹ 0.05. Both ROC curves resulted in equal areas under the curve of 0.951, p ‹ 0.05.
Conclusion: By eliminating the APACHE II of the NUTRIC score, collinearity is avoided, obtaining two cutoff points of 3 and 5 to detect low risk (sensibility = 99%) and high risk (specificity = 99%), respectively, and a score of 4 to perform an advanced assessment, optimizing its time.


REFERENCES

  1. Ferrie S, Allman-Farinelli M. Commonly used “nutrition” indicators do not predict outcome in the critically ill: a systematic review. Nutr Clin Pract. 2013;28(4):463-484.

  2. McClave SA, Taylor BE, Martindale RG, Warren MM, Johnson DR, Braunschweig C, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN). JPEN J Parenter Enteral Nutr. 2016;40(2):159-211.

  3. Heyland DK, Dhaliwal R, Jiang X, Day AG. Identifying critically ill patients who benefit the most from nutrition therapy: the development and initial validation of a novel risk assessment tool. Crit Care. 2011;15(6):R268.

  4. Rahman A, Hasan RM, Agarwala R, Martin C, Day AG, Heyland DK. Identifying critically-ill patients who will benefit most from nutritional therapy: Further validation of the “modified NUTRIC” nutritional risk assessment tool. Clin Nutr. 2016;35(1):158-162.

  5. Tolles J, Meurer WJ. Logistic regression: relating patient characteristics to outcomes. JAMA. 2016;316(5):533-534.

  6. Cerda J, Cifuentes L. Uso de las curvas ROC en investigación clínica. Aspectos teóricos-prácticos. Rev Chil Infect. 2012;29(2):138-141.

  7. Domínguez-Alonso E, González-Suárez R. Análisis de las curvas receiver-operating characteristic: un método útil para evaluar procederes diagnósticos. Rev Cubana Endocrinol. 2002;13(2):169-176.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Med Crit. 2017;31